A Case of Mitral Stenosis due to Pannus Formation after Mitral Valve Plasty

• Published in: Japanese Journal of Cardiovascular Surgery Vol. 53; no. 4; pp. 203 - 207
• Main Authors: Miyanaga, Tatsuya, Matsumaru, Ichiro, Nakaji, Shun, Hisatomi, Kazuki, Tasaki, Yuichi, Tanigawa, Akihiko, Taguchi, Shunsuke, Ryu, Yutaro, Murakami, Yugo, Miura, Takashi
• Format: Journal Article
• Language: English; Japanese
• Published: The Japanese Society for Cardiovascular Surgery 15.07.2024
• Subjects: mitral stenosis; mitral valve plasty; pannus
• ISSN: 0285-1474; 1883-4108
• DOI: 10.4326/jjcvs.53.203

A 73-year-old man had been followed up in our hospital after surgery for mitral regurgitation. At the age of 67, he underwent mitral valve plasty through a right mini-thoracotomy approach for atrial functional mitral regurgitation at our hospital. The mean trans-mitral pressure gradient was 5 mmHg after surgery but no heart failure symptoms were observed. At the age of 72, he began to notice fatigue during exertion. Transthoracic echocardiography revealed that the mitral valve regurgitation was controlled to a trace level, but the mean trans-mitral pressure gradient increased to 10 mmHg. Transesophageal echocardiography and contrast-enhanced cardiac computed tomography revealed the restricted opening of the mitral valve and pannus formation around the prosthetic ring. We thus diagnosed mitral stenosis due to pannus overgrowth. He underwent pannus excision and removal of the artificial ring. Postoperative echocardiography revealed that the mean trans-mitral pressure gradient was reduced to 3 mmHg and no residual mitral regurgitation was observed. He was discharged on postoperative day 11 with no major symptoms. He was in New York Heart Association functional class I at 1 year after the surgery and continues to be an outpatient.